title: Lifestyle modification programs in polycystic ovary syndrome: systematic review and meta-analysis.
abstract: BACKGROUND
  Polycystic ovary syndrome (PCOS) is a prevalent disorder that affects women of childbearing age and may be related to obesity and insulin resistance.
  
  
  OBJECTIVE
  The purpose of this systematic review was to appraise the evidence of the impact of lifestyle modification (LSM) interventions on outcomes of women with PCOS.
  
  
  METHODS
  Sources included Ovid Medline, OVID Embase, OVID Cochrane Library, Web of Science, Scopus, PsycINFO, and CINAHL (up to January 2011).
  
  
  METHODS
  We included randomized controlled trials that enrolled woman of any age with PCOS who received LSM and compared them against women who received no intervention, minimal intervention, or metformin.
  
  
  METHODS
  Two authors performed the data extraction independently.
  
  
  RESULTS
  We included 9 trials enrolling 583 women with a high loss to follow-up rate, lack of blinding, and short follow-up. Compared with minimal intervention, LSM significantly reduced fasting blood glucose (weighted mean difference, -2.3 mg/dL; 95% confidence interval, -4.5 to -0.1, I² = 72%, P = .04) and fasting blood insulin (weighted mean difference, -2.1 μU/mL, 95% confidence interval, -3.3 to -1.0, I² = 0%, P < .001). Changes in body mass index were associated with changes in fasting blood glucose (P < .001). Metformin was not significantly better than LSM in improving blood glucose or insulin levels. We found no significant effect of LSM on pregnancy rate, and the effect on hirsutism was unclear.
  
  
  CONCLUSIONS
  The available evidence suggests that LSM reduces fasting blood glucose and insulin levels in women with PCOS. Metformin has similar effects. Translation of these short-term effects to patient-important outcomes, beyond diabetes prevention, remains uncertain.
authors.affiliation: MD, MPH, Knowledge and Evaluation Research Unit, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905. murad.mohammad@mayo.edu.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Domecq
authors.forename: Gabriela
authors.initials: G
authors.lastname: Prutsky
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Mullan
authors.forename: Ahmad
authors.initials: A
authors.lastname: Hazem
authors.forename: Vishnu
authors.initials: V
authors.lastname: Sundaresh
authors.forename: Mohammed B
authors.initials: MB
authors.lastname: Elamin
authors.forename: Olivia J
authors.initials: OJ
authors.lastname: Phung
authors.forename: Amy
authors.initials: A
authors.lastname: Wang
authors.forename: Kathleen
authors.initials: K
authors.lastname: Hoeger
authors.forename: Renato
authors.initials: R
authors.lastname: Pasquali
authors.forename: Patricia
authors.initials: P
authors.lastname: Erwin
authors.forename: Amy
authors.initials: A
authors.lastname: Bodde
authors.forename: Victor M
authors.initials: VM
authors.lastname: Montori
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Murad
mesh_terms: D003131:Combined Modality Therapy; D004038:Diet, Reducing; D019317:Evidence-Based Medicine; D015444:Exercise; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000209:etiology / Q000517:prevention & control; D006946:Hyperinsulinism / Q000209:etiology / Q000517:prevention & control; D008019:Life Style; D059012:Lost to Follow-Up; D050177:Overweight / Q000150:complications; D010349:Patient Compliance; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy*; D011247:Pregnancy; D018873:Pregnancy Rate; D016032:Randomized Controlled Trials as Topic